Differential expression of CCR4 in primary cutaneous gamma/delta (γ⁄δ) T cell lymphomas and mycosis fungoides: significance for diagnosis and therapy

Publication date: Available online 1 September 2017
Source:Journal of Dermatological Science
Author(s): George Jour, Phyu P. Aung, E. Dean Merrill, Jonathan L. Curry, Michael T. Tetzlaff, Priyadharsini Nagarajan, Doina Ivan, Victor G. Prieto, Madeleine Duvic, Roberto N. Miranda, Carlos A. Torres-Cabala
Primary cutaneous γ⁄δ T cell lymphomas (PCγδTCL) are rare and usually aggressive T cell lymphomas. Expression of markers potentially useful for therapy, such as CCR4 and other molecules implicated in Th-like immune response may help to better understand these tumors and has not been reported to date.Ten PCγδTCL (5 showing epidermotropism) and 10 MF skin biopsies from 19 patients were studied. Immunohistochemical expression of CCR4, CXCR3, GATA-3, and IL-17 was examined and scored using quantitative and semi quantitative methods <ABS-P>CCR4 was expressed in 10/10 (100%) of MF and in 1/9 (11%) PCγδTCL cases (p=0.001). No significant difference in CXCR3 and GATA-3 expression was found between MF and PCγδTCL, although PCγδTCL did not display a Th2-like phenotype, contrary to MF. IL-17 showed very low (<20%) staining in most of the cases, with detection of rare strongly positive cells in 3 cases of PCγδTCL.Lack of CCR4 expression in PCγδTCL, including epidermotropic variants, suggests that these patients are less favorable candidates for therapy with mogamulizumab. Differential expression of CCR4 and absence of Th2-like immune profile may support the contention that epidermotropic PCγδTCL and MF are indeed biologically distinct. Expression of CCR4 may potentially be used in the differential diagnosis between epidermotropic PCγδTCL and MF.



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